Too Sick to Work?

You rise from a fitful night’s sleep with a sore throat and headache. Your temperature is slightly over 100 degrees, but judging by how crummy you feel, you wonder if it will spike to 103 degrees by day’s end. Should you drag yourself to work and risk infecting coworkers? Or should you phone in sick, even though your boss desperately needs you to pitch in during a stressful week?

“People are concerned about calling in sick, but if you’re really feeling unwell and especially if you have a fever, you need to stay home,” says Catherine Cummins, MD, MSN, a health sciences assistant clinical professor at the University of California-Irvine School of Medicine. “A little bit of common sense goes a long way.”

What should you take into account when deciding whether you're too sick to work?

How well can you carry out your work duties? If you’re feeling quite sick, “you’re going to have a hard time functioning and performing at your normal level,” Cummins says.

Are you contagious? If you have a viral or bacterial illness, you’ll expose your coworkers and they in turn will infect others. Staying home when you’re sick helps to curb germs in the community. “It’s to contain the illness,” Cummins says.

Will resting at home help your body to overcome the illness? “We see a lot of worsening symptoms because people will just not stop and rest. They want to go; they want to be able to do everything that they normally do,” Cummins says. “What they don’t understand is that they’re pushing themselves to the point where they’re actually a lot sicker at the end of two to four days than they would have been if they had just taken that first day off and let their body fight the infection.”

Are you taking medications that could impair your ability to think, work, operate machinery, or drive? Let’s say, for example, that you’ve been prescribed Vicodin for back pain and it’s causing fuzzy thinking. “If you’re so sick that you’re using opiates or any controlled substance to control pain, you really need to stay home,” Cummins says. “You shouldn’t be driving, and you could have your performance impaired or it could even be dangerous.”

Lastly, use the golden rule, Cummins says. “Treat others as you would like to be treated. Think about if you would like it if someone came to work and coughed on you all day.”

Here are some guidelines on some common conditions that can make us too sick to work.

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Too Sick to Work: Colds and Flu

You wake up with a scratchy throat, followed shortly by sneezing, a runny nose, and coughing. It could be the common cold, which is most contagious during the first two days after symptoms start.

The onset is most infectious because of “a high viral load,” Cummins says, “but people can be contagious for several days or even up to a week.”

A cold doesn’t always bring fever, but some people develop a mild one at the beginning.

“Even though fever makes you feel terrible, it’s actually your friend because it’s your body’s attempt to get rid of whatever ails you,” says Linda Haynes, MD, an associate clinical professor of family medicine at the University of Pittsburgh School of Medicine.

What’s a true fever? Many patients, even nurses on occasion, will report a fever to Haynes if they get a thermometer reading of 99 degrees. “That’s not a fever,” Haynes says. “Technically, we consider a fever anything over 100.3 degrees.”

Resting at home when you have a fever or severe cold symptoms, such as lots of coughing and sneezing, will not only aid your recovery, but also spare your coworkers from infectious droplets.

If you have mild coughing and sneezing and no fever -- and you feel that you need to go to work -- take measures to reduce chances of infecting others. Be sure to cover your mouth when sneezing or coughing. Wash your hands frequently to prevent transmission, or use alcohol-based hand sanitizers.

Compared to colds, flu symptoms are more severe and tend to come on abruptly. The flu also penetrates deeper into the respiratory tract. Often, the flu announces itself with chills. Fever is also common in the first few days, and a sick person’s temperature may rise to 102 or 103 degrees. Other flu signs: muscle aches, headache, a runny nose, sore throat, cough, weakness, and fatigue.

The flu delivers a punch powerful enough that many people want to take to bed for a few days. Again, fever and severe symptoms are strong signs that you're too sick to work and should stay home. The flu usually goes away in seven to 10 days in otherwise healthy people, although they may still have a cough and feel tired when they return to work. Although most people will need a few days off to recuperate, they can go back to the workplace 24 to 48 hours after their temperature has returned to normal.

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Too Sick to Work: Sinus Infection

An acute sinus infection can cause yellow or green nasal discharge, nasal stuffiness, facial pain or pressure, headache, or aching in the upper jaw and teeth.

If you feel too sick to work, stay home. You may have so much throbbing facial pain or headache that you can’t concentrate on your job. Try some self-care.

But if symptoms don’t improve in a few days or get worse, it’s time to see the doctor, who may treat you with antibiotics.

What about flying for business? Neither Haynes nor Cummins counsels patients to absolutely avoid airplanes if they have a sinus infection. But both urge caution because air pressure changes inside the cabin may worsen pain, especially on takeoff and landing.

“If you’re really sick, I wouldn’t travel anyway,” Haynes says. “But if you have a mild sinus infection and you have to travel, take a decongestant and/or antihistamine before you get on the plane.”

In rare cases, flying with a sinus infection could cause a ruptured eardrum, Cummins says. “It’s a very sudden, painful event, often followed by a bit of blood that may come out of the ear.”

“That sounds like a horrible thing,” Haynes says, “but most of the time, it would heal itself.” A ruptured eardrum typically repairs within two months; any hearing loss is usually temporary.

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Too Sick to Work: Pinkeye

Pinkeye, or conjunctivitis, causes eye redness, tearing, itching, burning, or swollen eyelids. Eye discharge can be clear and watery or copious and yellow or green, and it can make your eyelids stick shut in the morning.

When pinkeye stems from a viral or bacterial infection (as opposed to allergies or irritation), it’s highly contagious; and you’d be smart to avoid going to work. If you touch your eye, the discharge that contains the bacteria or virus ends up on your hand. When you touch objects, the germs can spread.

Antibiotics don’t work against viral pinkeye, but the condition will improve on its own, usually in three to five days. Consider staying home for a few days until you get better. When you return to work, avoid touching your eyes and wash your hands often.

Bacterial pinkeye does respond to antibiotic eye drops. You can go back to work 24-48 hours after starting this treatment, Haynes says.

Too Sick to Work: Back Pain

An aching back is so common that it’s a major reason for doctors’ visits, Haynes says.

Many people figure out ways to manage mild back pain on the job. But sometimes it makes good sense to take time off to relieve stress on your sore back, for example, if your job involves a lot of bending or lifting heavy objects, she says.

Sitting at a desk for long hours can also worsen back pain. If the pain is strong enough to distract you from your tasks, or if you have trouble sitting, standing, or walking comfortably, a couple of days off may help.

If you take a day or two off from work, be aware that lying still all day isn’t the best solution, Haynes says. “The best thing for back pain is actually mild to moderate movement. You don’t want to completely stop moving. Somebody who goes to bed and just lies there is going to prolong their recovery.”

If you have more serious symptoms, such as pain radiating down the leg, muscle weakness, or intolerable back pain, call your doctor promptly, Cummins says.

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Too Sick to Work: Staph Skin Infections

You see an ugly boil on your skin and wonder if a spider bit you. As the abscess becomes redder and more swollen and painful, you visit your doctor and discover that you have a staph skin infection, or perhaps even methicillin-resistant Staphylococcus aureus (MRSA).

Thanks to scary headlines about MRSA, “people panic when they hear the term ‘staph,’” Haynes says. But “the community-acquired staph aureus infections are much less troublesome than ones that somebody might pick up in a hospital,” she says.

Community-acquired staph infections are also more easily treatable. In rare cases, though, they can become more serious, invasive infections, so it’s crucial to bring any skin abscesses or boils to your doctor’s attention.

Although MRSA should be taken seriously, “It’s not like if somebody tells you that you have a staph infection that you’re going to die,” Haynes says. The infection can be treated.

Nor does an MRSA infection automatically rule out going to work.

MRSA is most frequently transmitted by direct skin-to-skin contact or by sharing contaminated items, such as towels or uniforms. “It’s only a problem if there’s a break in the skin, which becomes an entry for infection,” Haynes says.

The bottom line: Check with your doctor about going back to work. If your doctor gives you the OK, keep the affected area bandaged and wash your hands frequently while you’re at work. Someone with MRSA should avoid going back to work if the pus and wound drainage can’t be completely contained under a clean dry bandage, the CDC says, or if the worker can’t maintain “good hygiene practices,” such as keeping hands clean and declining to share personal items. As a further precaution, if you have an active MRSA infection, avoid any activities that could expose coworkers to skin-to-skin contact with the infected area until it’s healed.

“Remember, it’s a contact problem,” Haynes says. “If you sit at a computer and don’t have contact with anybody else, you probably could go to work.”